Frequently Asked Questions

Do I need to be referred by my dentist to have implants?

No. Anyone can make an appointment for a consultation.

What should I expect on my first visit?

Your first visit is your consultation with our implant dentist, Dr. Declan Furlong. The consultation will last for 45 minutes and Dr. Furlong will examine all your teeth and may also take some x-rays. We will discuss your concerns with you and explain the different types of treatment that are available to you. We will also go over fees and give you a print out of your treatment plan and fees to take home with you.

How soon can I start my treatment after my consultation?

Generally between 2-4 weeks.

Can I spread my payments out over the course of treatment?

Yes, you can spread your payment over the course of your treatment. You can pay per appointment, or set up a monthly standing order, whichever method suits you. Remember, dental implant treatment is 20% tax deductible.

How do I claim the 20% tax back?

At the end of the year, ask our reception staff for a Med 2 form and we will fill it in for you. You can either collect it at your next appointment or we can post it to you.

What is the implant made of?

Implants are made from Titanium. This is a biocompatible metal and has been in use for over 50 years as the most safe, successful and scientifically studied material for dental implants.

How successful are implants?

Implants have a 95% success rate - one of the most successful treatment options available in dentistry. This is based on someone being a suitable candidate. A good candidate is someone who is fit, healthy and well, is a non-smoker, has no active gum disease or decay and looks after their teeth well. It is also important that there is sufficient volume of jawbone and gum tissue in the area where the implant is placed.

How long do implants last?

Implants are the closest thing to a natural tooth root and have the capacity to last a lifetime, but it is hard to give an exact lifespan. Looking after your teeth & the implant will increase it’s longevity. The crown on an implant may need to be replaced every 10 – 15 years but can often last longer. Dentures supported by implants may need to be replaced every 5 – 10 years.

Are there any age limits for getting implants?

There is no upper age limit once someone is healthy and suitable for implants.

We avoid placing implants until the jaws have fully developed. Therefore, we do not place implants until patients are 18/19 years old. This will vary from person to person based on their individual growth pattern.

How does smoking affect implants?

Smoking decreases the blood supply to the jawbone, making all forms of healing in the mouth less predictable. This also affects dental implants. It doesn’t mean that an implant won’t work, but each case must be assessed on an individual basis. All smokers who wish to proceed with treatment are advised to quit 3 months prior to the first procedure. If the patient doesn’t feel that this is realistic, a cessation period of 2 weeks prior and 2 weeks after certain procedures (tooth removal, grafting, implant placement) can help improve healing predictability. If the cessation period is not achievable, in a small number of cases it may be possible to proceed with treatment - but the patient does so at their own risk.

When is it the best time to plan for an implant?

If you need to have a tooth removed, the best time to plan for an implant is before the tooth is taken out. It is usually best to have the tooth removed by the implant dentist. This is because it will allow them to plan the ideal time for implant placement. This may be the same day that the tooth comes out or it may be up to 9 months after the tooth is removed, depending on the presence of tooth or socket fractures and the degree of infection.

If a bone regeneration procedure is required it is often best done on the day of tooth removal to create an ideal foundation for the implant.

The implant dentist can also use certain instruments and techniques for the tooth removal, which are specifically designed to preserve the gum and bone for future implant placement.

What will happen if I do not replace the tooth with an implant?

Once a tooth is removed, the bone and gum volume in this area shrink. So the longer a tooth is missing the less suitable it may be for an implant. Each case is individual. This bone and gum loss may affect neighbouring teeth.

Opposing teeth may drift down into the space and neighbouring teeth may tilt into the space. These tooth movements may negatively affect your bite and may leave you more prone to gum disease or decay on the tooth root due to development of areas that are difficult to clean and prone to plaque build up.

How long does it take from start to finish?

It depends on the type of treatment.

1: Tooth is already missing:

no bone regeneration required - 6 months

bone regeneration required - 15 months

2: Tooth needs to come out:

back tooth - 9 months

front tooth - 12 months

front tooth with infection - 15 months

3: Replace/Stabilise Dentures

teeth already missing - 6 months

teeth to come out - 9 months

Each case is individual. Dr. Furlong will explain how long your case is likely to take.

How many procedures are involved?

There are 5 main procedures in replacing a single tooth

Removal of the tooth – you may have a fractured or infected tooth still present that needs to be removed prior to implant placement. We use special instruments and techniques to carefully and gently remove these teeth. This helps to preserve the surrounding gum and jawbone, which support the tooth and will need to be present to support the implant.

BACK & SIDE TEETH usually have good bone support and after removal of the tooth and a healing period of about 3 months, an implant can usually be placed.

FRONT TEETH have much thinner bone support, which is quite fragile. The job of the jawbone is to hold teeth in place. Once the tooth is gone, the jawbone’s job is done and it starts to dissolve away (much like a muscle, that isn’t being used, wastes away). This is particularly noticeable on front teeth. Therefore it is important to preserve the jawbone while the socket heals. We do this by placing graft material into the socket after we have removed the tooth. The graft material acts as a scaffold, helping to preserve the bone. The graft material slowly dissolves over 6-9 months and as it does it is replaced by the surrounding jawbone. The graft material used most commonly come from a Tissue Bank. We also use graft material that is Bovine in nature. Both are highly predictable and are very carefully screened and treated prior to use. There are synthetic and organic alternatives but they are less predicable in terms of bone regeneration.

Under current regulations, If bovine graft material is used, you must wait 1 month after the procedure prior to donating blood. If tissue bank graft material is used, you will no longer be able to donate blood.

It is a straightforward procedure. Afterwards, it will be tender for a few days and we will make sure you have the appropriate pain relief. You will be with us for about 45 minutes when removing a back tooth and for about an hour if we remove a front tooth and fit a temporary tooth.

Implant Placement – Placement of the implant underneath the gum, into the position where the tooth root used to be. This is a similar procedure to having a large filling done. Once the gum is numb, there will be some water and noise but it will not be sore. Afterwards, it will be tender for a couple of days and we will make sure you have the appropriate pain relief and antibiotics. You will be with us for about an hour.

Uncovery – 3 months after implant placement, we carry out a small procedure on the gum over the implant to expose the implant and put a healing cap on top of the implant. At this point, we can assess how well the implant has healed into position. This is a small procedure and doesn’t require antibiotics or prescription pain relief. You will be with us for about 30 minutes.

Implant Crown Impression – About 6 weeks later we take moulds of your teeth and of the implant. We send these moulds to a dental technician who will construct the implant crown. This appointment will take about 45 minutes and is very straightforward.

Fit Implant Crown – About 3 weeks after the moulds are taken we try in your implant crown. If we are happy with the fit, bite and appearance, we fit the crown that day. Small adjustments that are required can be done at this appointment. If there are larger changes we wish to make, we may want to return the crown to the technician to make these changes. This appointment will take about 45 minutes and is very straightforward.

Implant Dentures – There is a sequence of about 6 appointments to make up an implant supported denture. This can be started 2 weeks after the uncovery appointment and takes about 2 months to complete.

Is the implant visible?

The implant is placed totally under the gum into the position that the root was in. After the first week of healing, you won’t know it is there. At the Uncovery appointment, a small healing cap is placed on the implant and this barely comes up through the gum. Any temporary tooth will be adjusted to fit over it.

In some cases, if everything is ideal, the healing cap can be placed on the implant, the day the implant is placed.

Will I be left with a gap until the end of my treatment?

For a front or side tooth, we can construct a temporary tooth appliance first of all, so that we can fit it the same day that the tooth is removed. This way, you will never be left with a gap.

For back teeth it is not usually necessary to have a temporary tooth.

What will the temporary tooth look like?

The temporary tooth most commonly used is a removable appliance similar to a removable brace. It holds in place by fitting closely to the front part of the roof of the mouth and the surrounding teeth. The tooth will look like your own tooth but will have it’s limitations. It is not designed to take biting pressure so avoid chewing directly on it. It takes a few days to get used to speaking with it in. Don’t worry if you lisp at first and you may find more saliva in your mouth. You will adapt to the appliance in a few days.

There is a knack to taking the temporary tooth in and out. Dr. Furlong will show you how to do this. Again, after a few days this will be straightforward to do. After surgical procedures we will get you to leave the appliance in at night as it acts as a bandage, protecting the healing area. Also the gum will swell after certain procedures. If the temporary tooth is left in over night, the gum will swell around the temporary tooth. If the temporary tooth is left out, the gum will swell wherever it wants to and it may be difficult to put the temporary tooth back in the next day because of the swollen gum.

Clean the temporary tooth with cold water and a toothbrush, over a sink filled with water. Be careful handling and storing the temporary tooth, as it is fragile.

We use both dissolvable and non-dissolvable stitches depending on the case. Any stitches that need removal will be done 1-2 weeks after the procedure. This is a simple procedure and doesn’t require any anaesthetic for the gum.

Does it hurt getting implants?

No. It is the same sensation as getting a filling. We give you some local anaesthetic, just like you would have when getting a filling. Once that is done, you will not feel anything.

Will I be sore afterwards?

It will be tender for a couple of days but we will make sure you have appropriate pain relief. You may have a small bit of swelling and that could last for a couple of days. Dr. Furlong will give you instructions on how to look after yourself and we will always contact you a day or two after the procedure to make sure everything is settling down ok.

Will I get much swelling?

It depends on the type of procedure and the size of the area being worked on. Any facial swelling will be in the cheek/jawbone over the area of the procedure. The swelling will be up as much as it’s going to be by the 2nd day and will be gone 2 days after that.

Removal of back tooth/implant placement at back tooth

Minimal amount of swelling. Unlikely to be any visible swelling in the cheek/jawbone.

Removal of front tooth/implant placement of front tooth

Small amount of swelling to be expected. May be noticeable on the upper lip.

Larger amount of swelling. Visible swelling to be expected over the lip/cheek/jawbone. In rare cases can extend up to the eye. Small chance of bruising.

The best way to keep swelling to a minimum is to use an ice pack (bag of frozen peas etc.) over the jawbone/cheek as often as you can for the first 36 hours after the procedure. Any swelling you have will be up as much as it’s going to be after the first 36 hrs.

The best way to bring swelling back down is to use a hot pack (hot water bottle etc.) as often as you can over the swollen area starting 36 hours after the procedure and for the next 48 hours.

Will I have to take time off work?

This will depend on the type of treatment you are having done and the type of work that you do.

- For 1 or 2 implants, you should be able to work the next day.

- For more than 2 implants you may need to take a day or two off work.

- If you are having bone regeneration procedures we recommend you take 3 - 4 days off work, depending on the procedure.

- If you have a new temporary tooth appliance fitted when a tooth is removed, you may need to take a day off work as your speech will need to adapt to the appliance.

- If you wear dentures that replace all of your teeth you may need to keep the dentures out (on the jaw where the implants went in) for a week after the procedure to keep pressure off the gum.

It is advisable to plan procedures such as tooth removal, bone regeneration or implant placement, so that you are not travelling or do not have big events (i.e. weddings, big work presentations) for the following week, just to ensure everything is given a chance to settle fully.

Avoid strenuous exercise for the first week after a procedure. Any exercise that increases your heart rate will increase the blood flow to the healing area which may increase swelling in the area, leave you more prone to bleeding from the site and may loosen the stitches.

Dr. Furlong will advise if you need to take time off work and when you can return to normal activities.

What should I use to keep the healing area clean?

Avoid using a toothbrush in the healing area, and also 1-2 teeth either side. The toothbrush might disrupt the stitches. Use warm salt water mouthwashes (1 teaspoon of salt in a cup of warm water) or use a chlorhexidine mouthwash (corsodyl or kin). Wait 36 hours after the procedure and then rinse 4-5 times/day for 2 weeks. Keep food away from the area for 2 weeks.

What is a dry socket?

After a tooth is removed the socket heals by forming a blood clot within the socket.

This has 2 functions

It acts as a barrier preventing debris from getting into the socket.

It contains the cells and nutrients which accelerate healing.

The blood clot takes about 36 hours to fully develop. If you rinse your mouth during the first 36 hours after having your tooth removed, you may flush out the immature blood clot, leaving an open wound. This is likely to develop into a dry socket.

The area will start to ache and throb about 3 days after the procedure and this will last for about 7-10 days. It is inflammation of the socket and not an infection of the socket, so antibiotics will not help.

If you are concerned that you might have a dry socket, contact the surgery immediately and we can arrange to see you. We will gently rinse the socket and place a sedative dressing, which will help the socket to settle down.

Smokers are more prone to dry sockets and it is more common in the lower jaw than the upper jaw.

Helpful Hints prior to appointments.

DENTURE ADHESIVE – Please avoid using denture adhesive prior to an appointment. This can make working on the gum or taking moulds of your teeth or gums difficult.

MAKE UP – Please avoid wearing make up prior to a surgical procedure. We use 2 types of antiseptic face wipes to cleanse the skin around the mouth, upper lip, nose and chin to prepare the area for surgery.

PARTIAL DENTURES, RETAINERS & OTHER REMOVABLE APPLIANCES – Please bring them to all appointments as some adjustment may need to be made to allow their continued wear following that day’s procedure.

Thank you for assistance with these matters.

I want to whiten my teeth. When is the best time to do it?

If you are planning on whitening your teeth, this should be started about 1 month after the implant is placed under the gum. It should be completed at least 2 weeks before the records are taken for the implant crown.

My temporary denture has become loose. What should I do?

Don’t worry. This can happen as the gums settle after a procedure. Contact the clinic and we will book you in to have your denture adjusted.

My implant crown is loose. What should I do?

This is rare but if this does happen, contact the clinic immediately and we will arrange an appointment to refit the loose crown. Remember to bring your implant model with you.

Why do I need to keep my implant model? Is it important?

It is very important to keep your implant model somewhere safe and where you can find it in the unlikely event that you will need it.

The implant model is the template the technician uses to create the implant crown. If your crown ever needs any repair work (if it becomes loose or if the porcelain chips) it is important to attend the clinic with the implant model to facilitate repairing the crown.

Is the work guaranteed?

Yes. As we are passionate about what we do and proud of our reputation, we offer a 5 year guarantee to our patients for dental implants.

5 YEAR DENTAL IMPLANT GUARANTEE

As we are passionate about what we do and proud of our reputation, we offer a five year guarantee to our patients for dental implants.

What does this guarantee cover?

This guarantee applies to any reasonable repair required to work that has been carried out by Dr. Declan Furlong at Northern Cross Dental.

The guarantee will be reduced or invalidated if:

Oral hygiene is neglected

Implant care instructions are not followed

You do not attend your general dentist for check-ups at least once every 12 months

You do not wear your prescribed night guard appliance every night

Removable restorations, such as partial dentures or full dentures are not used or maintained properly

Gum tissue or bone is naturally reducing

General illness is present which has an unfavourable effects on the jaw

This guarantee is only valid for remedial dental work. It does not cover travelling costs or time off work.

Dental Implants

Long-term studies and our experience show that the life expectancy of dental implants, dental implant crowns and dental implant dentures are largely dependent upon good patient hygiene, regular check-ups and avoiding grinding/wear damage.

Bone Regeneration

Bone Regeneration is predictable but may require more than one stage. The larger the volume that needs to be regenerated, the more likely that more than one procedure will be required.

Smoking is a contra-indication to bone regeneration procedures during the initial healing phase.

Smokers

Smokers have an increased risk of gum disease which could result in the loss of a dental implant.

Due to the increased risk of failure of dental implants in smokers, we provide smokers with a limited guarantee.

What is covered - remedial work to repair the crown, bridge or denture

What is not covered - loss of the implant during the first 6 month healing phase

- loss of the implant following localised gum disease

- treatment of gum disease around an implant

Dentures

The guarantee does not cover routine treatment which is to be expected due to wear and tear of components.